Compensation System for Work-Related Accidents Act

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1 Compensation System for Work-Related Accidents Act Act No. 45 of April 18, 1935, as amended (Contains amendments incorporated by: Act No. 39 of May 4, 1937 Act No. 137 of May 6, 1938 Act No. 74 of April 26, 1940 Act No. 43 of April 22, 1942 Act No. 52 of April 25, 1942 Act No. 160 of May 9, 1942 Act No. 160 of May 14, 1943 Act No. 284 of May 15, 1945 Act No. 298 of May 15, 1945 Act No. 401 of April 23, 1946 Act No. 384 of May 13, 1947 Act No. 16 of April 12, 1948 Act No. 134 of April 28, 1949 Act No. 48 of April 18, 1950 Act No. 74 of April 21, 1950 Act No. 100 of April 25, 1950 Act No. 124 of April 26, 1950 Act No. 155 of May 1, 1950 Act No. 163 of May 2, 1950 Act No. 405 of May 11, 1951 Act No. 21 of April 5, 1952 Act No. 160 of April 30, 1952 Act No. 182 of May 2, 1952 Act No. 115 of July 1, 1953 Act No. 57 of June 11, 1954 Act No. 60 of June 11, 1954 Act No. 88 of June 29, 1954 Act No. 70 of June 15, 1955 Act No. 36 of June 9, 1956 Act No. 52 of June 16, 1956 Act No. 68 of June 18, 1957 Act No. 89 of June 22, 1957 Act No. 94 of June 22, 1957 Act No. 136 of June 30, 1958 Act No. 72 of June 25, 1959 Act No. 79 of June 26, 1959 Act No. 88 of June 26, 1959 Act No. 96 of June 24, 1960 Act No. 101 of June 24, 1960 Act No. 53 of June 14, 1961 Act No. 7 of May 7, 1962 rev. June 25, 2012 Puerto Rico OMB Page 1 of 76

2 Act No. 92 of June 22, 1962 Act No. 29 of May 29, 1963 Act No. 74 of June 24, 1963 Act No. 50 of June 13, 1964 Act No. 13 of June 9, 1965 Act No. 69 of June 23, 1965 Act No. 47 of June 15, 1966 Act No. 63 of June 17, 1966 Act No. 111 of June 6, 1967 Act No. 22 of June 19, 1968 Act No. 48 of May 22, 1968 Act No. 103 of June 21, 1968 Act No. 103 of June 28, 1969 Act No. 13 of April 20, 1970 Act No. 68 of May 30, 1970 Act No. 53 of May 31, 1972 Act No. 101 of June 5, 1973 Act No. 49 of May 30, 1974 Act No. 52 of June 4, 1974 Act No. 63 of June 10, 1974 Act No. 15 of August 9, 1974 Act No. 57 of June 22, 1975 Act No. 116 of June 30, 1975 Act No. 117 of June 30, 1975 Act No. 17 of October 30, 1975 Act No. 67 of June 22, 1978 Act No. 41 of May 30, 1984 Act No. 53 of July 1, 1986 Act No. 57 of July 1, 1986 Act No. 98 of July 10, 1986 Act No. 99 of July 10, 1986 Act No. 114 of July 10, 1986 Act No. 19 of May 18, 1987 Act No. 20 of May 18, 1987 Act No. 41 of June 19, 1987 Act No. 50 of June 27, 1987 Act No. 90 of July 2, 1987 Act No. 22 of April 22, 1988 Act No. 40 of June 3, 1988 Act No. 41 of June 7, 1988 Act No. 61 of July 5, 1988 Act No. 16 of June 30, 1989 Act No. 31 of July 20, 1989 Act No. 83 of October 29, 1992 Act No. 6 of February 15, 1996 rev. June 25, 2012 Puerto Rico OMB Page 2 of 76

3 Act No. 63 of July 1, 1996 Act No. 200 of September 6, 1996 Act No. 219 of September 12, 1996 Act No. 236 of September 18, 1996 Act No. 209 of December 30, 1997 Act No. 299 of December 23, 1998 Act No. 312 of August 14, 1999 Act No. 312 of October 14, 1999 Act No. 314 of October 16, 1999 Act No. 62 of May 11, 2002 Act No. 94 of May 25, 2003 Act No. 224 of August 28, 2003 Act No. 162 of June 24, 2004 Act No. 198 of August 5, 2004 Act No. 257 of September 7, 2004 Act No. 263 of September 8, 2004 Act No. 343 of September 16, 2004 Act No. 284 of December 22, 2006 Act No. 147 of August 1, 2008 Act No. 98 of September 18, 2009 Act No. 141 of November 16, 2009) (Amendments non-incorporated: Act No. 206 of December 29, 2009 Act No. 212 of December 29, 2009 Act No. 77 of April 27, 2012) An act to promote the welfare of the inhabitants of the People of Puerto Rico in or regarding accidents causing death or injuries, or diseases or death caused by the occupation of the workmen in the course of their employment; to establish the duty of employers to compensate their workmen or the beneficiaries of the latter as defined in this Act, for sickness or death caused by the occupation, or for injuries or death independent of negligence, and to provide the means and methods for making this duty effective; to establish the form of insurance and to regulate the same; to continue State insurance as an exclusive form; to create an Industrial Commission; to determine its powers and duties; to create the office of Manager of the State Insurance Fund, and to define the powers and duties of said Manager; to empower the manager to extend the medical and hospital benefits of the workmen's accident insurance to employers working regularly at the manual labor on their farms, shops or small businesses; to establish the liability of the Commonwealth of Puerto Rico and its municipalities in regard to their employees and workmen, for disease or death caused by their occupation or for their injury or death in all public services and in works done by force account; to authorize the Industrial Commission to liquidate all such claims as may be pending in accordance with Act No. 85 of May 1928, as amended by subsequent laws, until the date on which this act takes rev. June 25, 2012 Puerto Rico OMB Page 3 of 76

4 effect; to appropriate the sum of one hundred thousand (100,000) dollars for the purpose of beginning the operation of this new act; to determine the liquidation of the claims and obligations of the Workmen's Compensation Fund prior to Act No. 85 of 1928; to provide for the appointment of Advisory Boards; to repeal all laws or parts of laws in conflict herewith; expressly to repeal Act No. 85 of May 14, 1928, as subsequently amended, with the exception of the provisions of sections 40 to 47, both inclusive, of this act, in regard to the decision and liquidation of the cases pending under said act, and for other purposes. Be it enacted by the Legislature of Puerto Rico: Section 1. Short title. (11 L.P.R.A. 1) This Act shall be known as "Compensation System for Work-Related Accidents Act". Section 1-A. Public Policy. (11 L.P.R.A. 1a) The Constitution of the Commonwealth of Puerto Rico in Article II, Section 16 of its Bill of Rights, acknowledges the right of every employee to protection against risks to his/her health in his/her work or employment. It may be construed that this right provides the inclusion of a social security system for the employee for injuries sustained at the workplace. For that reason, the Legislature acknowledges the principle that the risk of sustaining work-related accidents is a fundamental risk which necessarily requires government action. As it has been to the present, this government action must be based on the theory of the social contract, which consists of a fair and equal adjustment of the interests of both the employers and employees, by which both receive important benefits in exchange for the free exercise of their traditional rights or prerogatives. Workers, to a certain extent, waive their right to sue their employer in exchange for a benefit which could eventually be smaller, but which is reliable, immediate and certain. In order for the social contract to be favorable to the best interests of the worker, it is the intent and policy of the Legislature to offer all employees within the system the best and most comprehensive protection against work-related risks. To obtain the resolute collaboration of the employers regarding such maximum protection within the system, it is necessary to reduce to a minimum any costly litigations outside the system, thus acknowledging the principle upon which the contract is based by which the benefits provided internally by the system make up the financial substitute of the legal remedy. The public policy of the Commonwealth of Puerto Rico continues to favor a compensation system based on the principle of absolute legal responsibility. However, the same should be redirected in order to face the new social and economic realities of our modern society, considering the new challenges and problems under different perspectives with more effective remedies, so as to be able to update and improve the protection that should be offered to the Puerto Rican worker. As part of such a commitment, the following principles constitute part of the public policy of this Act: (a) Aware of the fact that no system is able to mitigate the suffering nor totally compensate for the financial and social loss caused by work-related injuries, it is of vital importance to develop vigorous and efficient programs within the system for the prevention of work-related accidents rev. June 25, 2012 Puerto Rico OMB Page 4 of 76

5 and occupational illness. The adoption of such preventive measures, through the establishment of specialized structures leading to the attainment of said purposes, constitutes an essential part of the public policy of the Commonwealth of Puerto Rico. (b) The injured worker should be guaranteed the best and fastest treatment that medical science is capable of providing, so that he/she may be able to return to his/her regular employment, totally recovered from the injury, within the shortest period of time possible. If it is not possible to achieve this primary objective because of permanent physical or mental impairment, it is indispensable to establish individual vocational rehabilitation programs, provided with the best and most advanced techniques developed in this field and with the proper financial incentives so that the worker may successfully take the maximum advantage of the rehabilitation program and thus return to the employment market without any loss of income; or, if this should be inevitable, that such a loss of income be the least amount possible. The vocational rehabilitation of the worker should start as soon as the injury occurs and should comprise not only the vocational rehabilitation and retraining plans, but also re-employment and occupational placement programs. (c) The financial protection or compensation that may be provided by the system should offer workers the best benefits. This includes, in the first place, providing financial aid to the worker during the total transitory disability period, so that he/she may be able to support himself/herself and comply with his/her basic obligations until he/she is ready to resume his/her previous job or a similar one and until his/her regular income from his/her employment is re-established. The permanent financial compensation provided by the system should first cover the worker's loss of income, reserving the compensation for the resulting physical disability only for the most critical cases. Finally, the Commonwealth of Puerto Rico recognizes that implementing and developing the above stated public policy requires fundamental changes in the bodies that will be most affected by the updating of our system in order to insure its proper functioning. To such effect, the creation of the State Insurance Fund Corporation and an Industrial-Medical Board is hereby provided, with the responsibility of establishing quality and excellence criteria with regard to the service to be rendered by said corporation to the insured persons. Likewise, it restructures the Industrial Commission to harmonize its functioning with that of the aforementioned bodies. It is also essential that the results obtained with these changes be subject to an ongoing evaluation process by the Legislature in order to effect all those amendments and adjustments that may be construed as necessary to correct adverse or unsatisfactory results in the Act. Upon the culmination of the reform process of the system through this joint effort, the objectives which constitute the public policy of the Commonwealth in the area of protection of our working class in those cases of work-related injuries should be fully attained. Section 1-B. The State Insurance Fund Corporation. (11 L.P.R.A. 1b) A corporation, as an instrumentality of the Government of the Commonwealth of Puerto Rico, is hereby created in order to carry out the purposes of this Act, to act, by authority of the same, under the name of "State Insurance Fund Corporation." (1) Authority and general powers. (11 L.P.R.A. 1b-1) The corporate powers shall be exercised by a Board of Directors hereby created that shall be responsible for insuring that the provisions of this Act are enforced. rev. June 25, 2012 Puerto Rico OMB Page 5 of 76

6 The Corporation shall have all the necessary or convenient powers to carry out and accomplish the purposes and provisions of this Act, including, without it being a limitation to the aforementioned, the power to: (a) Exist in perpetuity as a corporation. (b) Adopt an official seal and alter same as required by circumstances. (c) Keep offices in the place or places thereby determined. (d) Sue and be sued in its name; to file accusations and be accused. (e) Receive, administer and comply with the conditions and requirements regarding any gift, grant or donation of any property or money. (f) Prepare, formalize and award agreements, leases, contracts and other instruments that may be necessary or pertinent in order to exercise the duties and powers of the Corporation with any person, firm, corporation, federal agency and with the Commonwealth of Puerto Rico and any of its political subdivisions, agencies or political instrumentalities. (g) Contract with any person, firm or corporation for the administration of facilities and programs or for consultant or advisory services. (h) Acquire, for corporate purposes, any property, personal or real or the interest on same, including, but not limited to, its acquisition by purchase, whether through an agreement or by means of eminent domain, lease, offer to exchange or donation, and to own, preserve, use and exploit such property or the interest on same. (i) Sell, lease or otherwise dispose of any property which the Corporation deems no longer necessary to carry out the purposes of this Act. (j) Use the reinsurance technique, as deemed necessary or convenient, in order to stabilize the losses, increase the risk subscription capability of the Corporation or to safeguard its financial solvency. When using said technique, the Corporation shall be obliged to establish the maximum risk retention limits, commensurable with its financial capability. (k) Establish an adequate and vigorous coordinated program, on its own facilities or through contracts with public or private agencies or entities, to achieve the physical as well as vocational rehabilitation of employees disabled as a result of injuries caused by accident or illness in the course of employment. (l) Take any action as may be necessary or convenient to discharge the powers conferred by this or any other Act; Provided, however, That the Corporation shall not have the faculty to pledge the credit of the Commonwealth of Puerto Rico or of any of its political subdivisions. (m) Develop and execute programs oriented towards the prevention and reduction of occupational accidents and/or illnesses. (n) Enter into contracts or agreements with other public agencies and organizations in charge of protecting occupational health and safety. (o) By virtue of the powers hereby conferred upon the State Insurance Fund Corporation, it shall be understood that this is a corporate instrumentality within the definition in subsection 11 of Section 2 of Act No. 130 of May 8, 1945, as amended [29 L.P.R.A. 63]. (2) Board of Directors. (11 L.P.R.A. 1b-2) The Board of Directors shall be composed of seven (7) members appointed by the Governor with the advice and consent of the Senate, all of whom shall represent the public interest and who, through their education and experience, possess the necessary qualifications to protect the financial solvency of the Corporation and the strict compliance of its objectives and social rev. June 25, 2012 Puerto Rico OMB Page 6 of 76

7 purposes. One of the seven (7) members shall be the Insurance Commissioner, who is a person of great technical competence in the insurance area; one shall be identified with the employers, another one, who on account of his vocation, employment or union affiliation, shall be identified with the employees and shall be considered as such; and two (2) members shall be officials of the Departments of Labor and Human Resources, and Health, recommended to the Governor by the Secretaries of said Departments. The two (2) remaining members, unrelated to the abovementioned sector, shall be freely selected. The Governor shall designate one of the seven (7) members as Chairperson for a term of six (6) years. The initial appointment of the three (3) government officials shall be for five (5) years and the remaining four (4) members shall be for four (4), three (3), two (2) and one year, respectively. Every subsequent appointment shall be made for a single additional term of six (6) years. Upon the expiration of the appointment of any member, his/her successor shall be appointed within a term of sixty (60) days. The incumbent shall continue performing his/her duties until his/her successor has taken to office. Board vacancies due to resignation, dismissal, physical or mental disability or death, shall be filled within a period of sixty (60) days from the date of occurrence, and shall be effective for the remainder of the term until the expiration of the original appointment. All members of the Board shall be legal residents of the Commonwealth of Puerto Rico and shall be subject to the provisions of Act No. 12 of July 24, 1985, as amended, known as the "Ethics in Government Act of the Commonwealth of Puerto Rico". Four (4) members of the Board shall constitute a quorum. The members of the Board shall discharge their functions without compensation, but they shall be reimbursed for every special expense incurred in the fulfillment of their duties, in addition to the regular per diems determined by the Board through regulations. The Board of Directors shall appoint a Secretary from among its members. The Governor, on his own initiative or by recommendation of the Board, may remove any of its members for just cause, upon the filing of charges and the opportunity to be heard. The Board shall establish the mechanisms to evaluate the performance of its members through regulations. (3) Authority and obligations of the Board. (11 L.P.R.A. 1b-3) The Board shall have the authority and the obligation to do the following: (a) Appoint an Executive Secretary. (b) Appoint an Administrator who shall be the Chief Executive Officer of the Corporation, who shall have those duties and functions assigned to him/her by the Board of Directors, according to the powers conferred upon the aforesaid. (c) The Administrator shall be appointed for a term of six (6) years, taking into consideration his/her technical educational background, experience and other qualities which enable him/her to achieve the goals of the Corporation. Said Administrator shall not engage in any private business or exercise any profession whatsoever during the term of his/her appointment. (d) Said Administrator shall direct and administer programs covering occupational accident and illness prevention, work injury and illness insurance and all services rendered to employees covered by the present Act. (e) Set the salary of the Administrator. rev. June 25, 2012 Puerto Rico OMB Page 7 of 76

8 (f) Remove the Administrator from office for any justified cause, upon prior notice and the opportunity of being heard. (g) Establish the coverage and amount of and the requirements for the bond of the Administrator and any other official or employee that should be covered by a bond, as determined by the Board. (h) Consider, reach agreements and issue resolutions on issues submitted by the Administrator. (i) Approve the necessary regulations to put into effect the provisions of this Act, subject to Act No. 170 of August 12, 1988, as amended, known as the "Uniform Administrative Procedures Act." Furthermore, it shall approve rules for its organization and internal operation. (j) Establish the administrative structure of the State Insurance Fund Corporation, including the systems, controls and standards for personnel remuneration, the budget, finances, purchasing, accounting, and any other administrative systems that may be necessary for a cost-effective and efficient service operation. (k) Hold regular meetings at least once a month, and special meetings as deemed necessary, and draw complete minutes of all procedures. (l) Contract, if deemed necessary, any advisors that may help the Board discharge the obligations and duties conferred hereby. (m) It shall have power to contract external auditors, who shall advise the Board of Directors as to the faithful compliance with the applicable laws, regulations and fiscal procedures, and who shall submit a full audit report on the fiscal activities of the System. (n) Approve the budget for those expenses that are necessary to perform the duties assigned hereby to the Corporation; Provided, That: (1) The administrative expenses, including expenses for medical services and hospitalization, shall not exceed twenty-two percent (22%) of the total income accrued on account of premiums during the previous fiscal year, and (2) the budget shall include an item set aside to cover the expenses apportioned in the budget of the Commonwealth of Puerto Rico for the operations and functions of the Industrial Commission, which item shall not exceed four percent (4%) of the total income accrued on account of the premiums during the previous fiscal year. The resulting differences between the amounts spent annually by the Industrial Commission and the Office of the Administrator of the State Insurance Fund, and the total amount available to said entities for their budgets as provided by virtue of this section, with the exception of medical expense remainders, shall be deposited annually in the Catastrophe Reserve Fund of the State Insurance Fund. (o) Establish procedures for the determination and revision of fees, collection of premiums and payment of claims. (p) Revise, approve and submit at the end of each financial year, but no later than the first of November of each year, an annual report to the Governor and the Legislature, containing, among other matters; a financial statement including an income and expense statement for the corresponding year, a balance sheet, and detailed reports of the claims filed at the Corporation during the year; a loss reserve certification prepared by a professional actuary in compliance with the standards of the National Association of Insurance Commissioners to certify the reserves of commercial insurers; a report on the investment and property titles of rev. June 25, 2012 Puerto Rico OMB Page 8 of 76

9 the Corporation; and any other statistical and financial data which the Board may deem necessary for an adequate interpretation of the Financial Statement of the Corporation. (q) Approve investments of the resources of the Corporation, subject to the provisions of Section 27 [11 L.P.R.A. 30] on the public policy on investments. (r) Make the corresponding recommendations to the Governor regarding the candidates to be appointed to the Medical-Industrial Council, as provided in Section 1-C of this Act and, once said Council is appointed, it shall aid and collaborate with the duties assigned to the aforesaid as provided thereby. (s) Keep up with the development of the system, so that it may be a dynamic one. The Board of Directors of the State Insurance Fund Corporation shall use its corporate powers to promote the Work Accident Compensation System established in this Act, in accordance with the objectives and purposes of the statement of public policy stated in Section 1-A [11 L.P.R.A. 1a]. To such effects, the Board of Directors shall submit to the Governor of the Commonwealth of Puerto Rico and to the Legislature, within one year after being constituted and from then on, on each subsequent year, a full and detailed report of the measure administratively adopted in order to comply with such a task. Said report shall contain, whenever possible, an evaluating analysis of the achievements and results attained thereof. In its annual report to the Governor and the Legislature, the Board of Directors of the Corporation must make mention on those areas which are in the process of being studied and considered for the purpose of complying with the task of reforming the Work Accident Compensation System. The Board of Directors of the Corporation shall also recommend, as soon as possible, those legislative measures that may be necessary to continue the reform process and which may be impossible to implement by administrative action. (4) Duties and functions of the Administrator. (11 L.P.R.A. 1b-4) In addition to the duties assigned to the Administrator by the Board of Directors in accordance with the powers conferred by it, the Administrator shall carry out the following duties and functions: (a) Take any administrative and managerial actions that may be necessary and convenient for the implementation of this Act and the regulations adopted by virtue thereof. (b) Adopt, upon approval of the Board of Directors, reasonable and adequate administrative guidelines and orders to implement and put into effect the provisions of this Act. (c) Oversee and supervise the coordination of the work accident prevention program and of the medical, hospitalization, and physical and vocational rehabilitation services, as well as the compensation payment and claims liquidation of employees. (d) Carry out studies and submit reports to the Board of Directors on the progress of the programs established for the benefit of the employees and to make recommendations as to possible changes and modifications to such programs. (e) Administer and operate, subject to the regulations in effect and the guidelines set by the Board of Directors, the Corporation's own health service facilities for the benefit of the employees. (f) Insure, pursuant to this Act and to regulations, all employers that by law should be insured by the State Insurance Fund Corporation. It is also provided, that the Administrator shall ensure the timely remittal of the workers' compensation insurance premiums imposed upon employers and municipalities. In the case of the municipalities, the notice of the imposition of the workers' compensation insurance premiums shall be sent either ninety (90) days in rev. June 25, 2012 Puerto Rico OMB Page 9 of 76

10 advance or by March 1, whichever term is the shortest, prior to the deadline for presenting the municipal budget. The Administrator shall implement the necessary mechanisms and approve the rules for compliance with the provisions set forth in this subsection. (g) Administer the Corporation's own personnel system and appoint all its officials, agents and employees, who shall be public employees entitled to membership with the Government Employees Association of Puerto Rico and to the benefits under the Retirement System of the Government of Puerto Rico, to confer the powers and assign the duties that may be deemed appropriate, as well as to set their remuneration subject to the personnel regulations established by the Board of Directors of the Corporation. The Corporation shall be exempt from the provisions of Act No. 5 of October 14, 1975, known as "Puerto Rico Public Service Personnel Act", and from the personnel regulations adopted by virtue thereof. However, the Personnel System to be established shall be based on the merit principle and shall conform to the rules and regulations adopted to such effects by the Administrator. (h) Impose on the officials, agents and employees of the State Insurance Fund Corporation the disciplinary measures that may correspond according to the regulations adopted to such effects by the Board of Directors. (i) Award contracts to health professionals and institutions or organizations engaged in rendering medical-hospital and health services, chargeable to budget authorizations approved by the Board of Directors, as may be necessary or convenient for the treatment of employees entitled to receive the benefits of the law. (j) Use actuarial services for reviewing and fixing rates, for determining reserves and for other legitimate purposes in the fulfillment of the obligations imposed by this Act or by the Board of Directors of the Corporation. (k) Authorize, carry out and supervise all disbursements that should be drawn against the State Insurance Fund Corporation pursuant to this Act and the regulations, and to the by-laws adopted thereof. (l) Acquire all the materials, supplies, equipment, parts or services that may be necessary or convenient for the operation of the Agency, subject to the applicable regulations and to Act No. 42 of August 5, 1989, known as "Preference Procurement Policy Act of the Government of Puerto Rico." (m) Give prompt attention to the determinations and recommendations of the Medical- Industrial Council, created by virtue of Section 1-C of this Act, in accordance to what is thereby provided. (n) Request, accept and use external funds, with the approval of the Board of Directors, in order to carry out programs, works or services approved in this Act. (o) Establish friendly work relations with other government agencies, hospital boards and other organizations including those related to occupational accident and illness prevention and the physical and vocational rehabilitation of disabled persons. (p) Make available the facilities of the Corporation, subject to cost reimbursement, for the treatment of any kind of injury or illness suffered by any member of the community, by means of contracts with the Department of Health, the Vocational Rehabilitation Office of the Department of Social Services or any other public agency or private institution that may wish to use the services provided by the Corporation. However, no contracts may be awarded if, by doing so, the services which the Corporation must render primarily to the employees under this Act are adversely affected. The Administrator shall also offer the facilities of the rev. June 25, 2012 Puerto Rico OMB Page 10 of 76

11 Corporation in emergency situations, subject to the aforesaid conditions, in accordance with the rules adopted to such effects by the Board of Directors. (q) Serve summons and compel the appearance of witnesses and the presentation of documents, through the officials, agents or agencies designated by him/her, and to issue certifications regarding those official acts assigned to the Corporation through this Act or delegated or entrusted by the Board of Directors. Section 1-C. Medical-Industrial Council. (11 L.P.R.A. 1c) (a) The Medical-Industrial Council is hereby created, consisting of seven (7) members, four (4) of which shall be doctors in medical sciences, of which one shall have experience in occupational medicine. These first four (4) members, whose professional training enables them to evaluate the medical services offered by the State Insurance Fund Corporation and the treatment that should be given to injured employees under the benefits of this Act, must have been admitted into the practice of medicine in the Commonwealth of Puerto Rico. The three (3) remaining members shall be a Health Services Administrator, a professional nurse, and a specialist in vocational rehabilitation or a social worker with experience in vocational rehabilitation, all of which shall be duly licensed under the laws of the Commonwealth of Puerto Rico. No member of the Medical-Industrial Council shall have any financial or professional relationship with the State Insurance Fund Corporation. One of the members of the Board of Directors of the State Insurance Fund Corporation, the Administrator of the State Insurance Fund Corporation and the Chairperson of the Industrial Commission may participate in the meetings of this Council without the right to vote. Five (5) members of the Council shall constitute a quorum. The seven (7) members of the Medical Council shall be appointed by the Governor, with the advice and consent of the Senate, and all of them shall represent the public interest. One of the seven members shall be designated as Chairperson by the Governor and may participate in the meetings of the Board of Directors of the Corporation without the right to vote. The term of the Chairperson shall be six (6) years. The initial appointment of the remaining six (6) members shall be for six, five, four, three, two and one year, respectively. Every subsequent appointment shall be for only one additional term of six (6) years. The Governor shall appoint two of the four members of the Council who shall be doctors in medicine, choosing one from each of two lists of five candidates submitted by the Secretary of Health and the Dean of the School of Medical Sciences. One of the two remaining members shall be designated in consultation with representatives of the labor movement and the other in consultation with representatives of the employer's sector. The three members that are not doctors in medicine shall be selected from an additional list of five candidates submitted to the Governor by the Secretary of Health and the Dean of the School of Medical Sciences, in consultation with the Dean of the School of Health-Related Professions, the Dean of the Graduate School of Public Health of said Medical School, and the Secretary of the Department of the Family, respectively. The list of candidates to be appointed to the Medical Council shall be accompanied by any such information that may allow the Governor to evaluate the suitability and capability of those professionals in the field of medical sciences that are being recommended. rev. June 25, 2012 Puerto Rico OMB Page 11 of 76

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